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Home My WebLink About2528 DUKE PL - Building Permits' � CITY OF COSTA MESA � a ��pMFq BUILDING DIVISION i .. .. � 77 FAIR DRNE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us : J V ��o�Ay FOR INSPECTIONS CALL: (714) 754-5626 PERMIT NUMBER: BX09-00216 PERMIT TYPE B MISC STATUS: ISSUED APN: 14141248 DATE ISSUED: 11/13/2009 Zoning: , ISSUED BY: RMD JOB ADDRESS: 2528 DUKE PL CM Vicinity: ROOF SQ. FT: 0 Suite/Unit: Primary Occ: Const Type :?? Valuation: $65,800.00 SCOPE OF WQRK: INSTALLATION OF A 6.58 KW ROOF MOUNTED PHOTOVOLTAIC SYSTEM FOR A SFD WITH AC/DC, 1 MISC CONDUIT, 1 MISC EQUIPMENT, 1 INVERTER. OWNER: STRICKLER, VERN M City/State: COSTA MESA, CA Phone: APPLICANT: MOORE, BILL City/State: Phone: 949_2gg_g549 CONTRACTOR: SUNTREKINC Address: 5 HOLLAND 215 City/State: IRVINE, CA Zip Code: 92618 ARCHITECT: Phone ENGINEER: Phone FEESUMMARY Building Plan Check: Building Permit: Electrical Permit SMIP Residential SMIP Commercial Bldg Std Admin Fund TOTAL FEES Address:: 2528 DUKE PL Zip Code: 92626 Address: Zip Cade: License No. 859460 Phone 949348-9276 $491.24 $755.75 $62.10 $6.58 $0.00 $3.00 $1,349.17 License No. License No. Cell: Unit Unit Unit: UNIT NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and relaled regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable wdes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. LO�EM. INSPECPONTYPF pTE IN101AL5 COOEC INSPECTIONTYPE DRTE INTITIALS 1616 Fizetl System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Finai Plumbing 'o/(��,, 200 Final Re-Rwf 210 Final Electnwl �. �J.101 � 201 FinalBlock/R@taining Wall 272 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site � 20d Final Demolition 250 Final Building/OCCupancy l��" WORKERS' COMPENSATION DECLARATION: I hereby aKrm under penalry of perjury one o( Ihe following declarations: ❑ I have and will maintain a certifwte of consent to self-Insure (or workers' compensation, as provided for by section 3700 of the Labor Code, for the peAormance of the work /or which this permil is issued. ❑ 1 have antl will mainlain workers' compensation insurance, as required by section 3700 of the Labor Cotle, for the pedortnance of the work for which this permit is issued. My workers' compensation Insurance carrier and policy number are: ///� �/� ) CCar'riei: //l /f/,F ` %�/.(l � (Thisseciionn ednol6ecomplefetlCAtbye/�rm0isvaluedafonehundretleoll s(S100Joiless) Poli y Number �� ) f % ��_ ❑ I certify Ihat in Ihe pertormance of the work for which this permit is issued, 1 shall not employ any person in any manner so as to become subject [o the workers' compensalion laws of California, and agree that i( I should become subject [o [he vrorkers' compensation provisions of Section 3700 of [he Labor e, I shall fort with c ply with ihese provisions. !�_��f%�r/I'/�- /� /.Z-D� �r_, - � � Dat�e:�t;L WARNING FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, IMEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby aKrm that I am licensed under pmvisions of Chapter 9(commencing with Seclion 7000) of Division 3 of the Business antl Professions Code, and my license is in full forc r�tl ec . _ Lic��#� G �Cia"�ss'# ' 2 _O . act�rs5ig �-^Da�e^•� ' C-.,�.:"' CONSTRUCTION LENDING AGENCV: ❑ I hereby affrtn that theie is a consWction lending agency for the peAortnance of Ihe work fa which this pertnit is issued. (Sea 3097, Civil Cotle). Lender's Name: Lender's Address: �ate OWNER-BUILDER DECLARATIONS: I hereby afTrm Ihat under penalty of perjury Ihat I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for lhe following reason (Sec. 7031.5, Business and Pro�essions Code: Any ciry or county which requires a permit to cons[ruct, alter, improve, demolish, or repair any slructure, prior to its issuance, also requires the applicant for such permit to file a signed statement tha[ he or she is licensetl pursuant to Ihe provisions o! Ihe Contrac�ors License Law (Chapter 9(commencing with Section 7000) of Division 3 of ihe Business antl Pmfessions Code) or that he or she is exempt there(rom and lhe basis for ihe allegetl exemption. Any violation of Section 7031.5 by any applicant for a permit subjects lhe applicant to a civil penalty ot not more Ihan five hundretl tlollars ($500).): ❑ I, as ovmer of the property, or my employees wiN wages as their sole compensation, WILL DO THE WORK, and the sWcture is not intended or offered for sale (Sec. 7044, Business antl Professions Cotle: The Contractors License Law does not apply to an owner of property who builds or improves thereon, and v+ho does such work himself or herself or through his or her own employees, provided ihat such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completioq the ovmer-builder will have Ihe burden of proving that he or she did not build or improve for purpose of sale.�. ❑ 1, as owner of the property, am EXCLUSIVELY CON7RACTING WITH LICENSED CONTRACTORS to cons[ruct Ihe projecl (Sec. 7044, Business and Professions Code: The cont2ctors License Law dces not appty to an owner of property who builds or impmves thereon, and who coNracts for such project vnth a contracta(s) license pursuaN lo the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: SignaWre Date 305]-46(3I01) Owner ID verifed by driver s license. ❑ Yes ❑ No - Driver's License No. Expires: Verifcation o! Ownership by (type of document, i.e. - property tax bill or tleed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certrfy that no excavation fve (5) or more feet in deplh into wfiich a person is required to descentl, will be made in connection vrith work authonzed by Ihis pertni[, and Ihat no building structure, scaffolding, falsework, or demolition or dismantling [hereof, will be more lhan thiAy-six (36) (ee[ high. (Chap. 3.2, Grp 2, Fvt 2, Sec 341, Ttle 8, Califomia Administrative Code). ❑ As owner-builtler, I will not employ anyone to tlo work which would require a permit from the Division ot Industrial Safery, as noted above, unless such person has a permit to tlo such work from the division. Apphcanfs SignaWre Division of Industrial Safe�y Permit Number: _ HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will the applicant or present or Wture building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? ❑ Yes ❑ No (Section 25505 of the California Health and Safely Cotle requires, vnlh some excep[ions, that a Business Plan be filed with ihe Costa Mesa Fire Department by every business which has at any one time dunng a reported year a quantity of hazardous materials equal to or grealer �han a weigh� o( 500 pountls, or a volume of 55 gallons, or 200 cubic feet of compressetl gas at standard [emperaNre and pressure). 2. Does or will Ihe applicant or present or fuWre building occupant need to file a reqistration form !or acutely hazardous materials? ❑ Yes ❑ No (Section 25533 of Ihe California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantiry of acutety hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet ol compressed gas a1 stantlartl IemperaNre and pressure). 3. Does or will Ihe applicant or presenl or fulure building occupant need lo prepare an RMPP (Risk Management and Prevention Program for acutely hazardous matenals)? ❑ Yes ❑ No (Section 25534 of [he Califomia Health antl Safety Code pmvides that the Cos[a Mesa Fire Department may require the prepara[ion, certificalion and fling with the Fire Depariment of an RMPP by businesses which are required to register acutely hazardous materials wi�h �he Fire Department. 4. If an RMPP is presently required, has Section 25534 of lhe Califomia Health and Sa(ety Code been (ully complied with? ❑ Yes ❑ No 5. Does or will the applicant or present or (uture building occupant require for the work which is Ihe subjec� of this application a permi[ for such construction or modifcation from the South Coast Air Qualiry Management Dislrict or from any o[her air polWtion contml district or agency? ❑ Ves ❑ No (Sectbn 658502 0( the Califomia Govemment Code requires that the requested infortnation be fumished on applications for nomresidential building permits). 6. Will any part of the facility to be constructed under this permil be within 1000 (ee[ from the outer boundaries of a school? ❑ Yes ❑ No Qf "yes", Ihe faciliry must meet Ihe requirement o( Sections 25534 and 42303 of [he Califomia Heaflh and Sa(ery Cotle). 7. If a permit from the South Coast Air Quali�y Managemen� District or other air pollution control dis[rict or agency is required for ihe vrork which is ihe subject of this application, have all of the disclosures prescribed by Califomia Health and Safety Code Section 42303 been made? ❑ Yes ❑ No 8. Q( yes", attach certificate of compliance from Ihe appropriale air pollution control oKcer�. CERTIFICATE OF COMPLIANCE: I certity that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signamre Da�e CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certity under penalty of perjury Ihat I have read Ihis application and state that the information given is correcL I agree to comply with all state laws and ciry ordinances relating to building construction, and authorize representatives of the City ot Costa Mesa ro enter upon the above-described pmperty for inspection purposes. I agree no[ to occupy or allow occupancy of any building authorized by [his permit until fnal inspec�ion. �naWreol�Leg�a'°i� s) Date �r� /�(�( ./ �Z't_ / % ��2'-�J`7 �� Avt�orizetl t �"Da�e�� , � CITY OF COSTA MESA ' BI/!lDlNG DIVISION � 77 FAIR DRIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • v+w.v.ci.wsta-mesa.ca.us FOR INSPECTIONS CALL: (714) 754-5626 PERMIT TYPE: 8 COMBO SubType: POOLSPA e PERMIT NUMBER: BC08-00440 STATUS: ISSUED DATE ISSUED: 0 911 2/2 0 0 8 ISSUED BY: RMD JOBq��Ress: 2528 DUKE PL CM' = Suite/Unit:�. . APN: 14141248 � - Zoning: ' , , � � � _ � . Vicinity: REAR YARD '° Primary Occ: R-3 Const Type: '� - SQ. FT:. 323 �• Valuation: $30,000.00 SCOPE OF WORK: CONSTRUCTION OF A 323 SF IN-GROUND GUNITE POOUSPA FORrA SFD W ITH 1 FAU OVER 100 K BTU, EL�CTRICAL FOR POOLJSPA &'PLUMB.FOR PRIVATE POO/SPA. � � ... - . ..�'��1.. � . ., � OW�ER; STRICKLER, VERN M_ ,� . Address: 2528 DUKE PL ` . � , Unit: Phone: � ` , -' � ' City/State/Zip: COSTA MESA, CA � � � � � . r APPLICANT: ELLISON, PAUL �-• � �- �Address: 24512 BRIDGER RD - � � � -. Unit: . Phone: 949•859•8466 � � � , City/Stale/zZip: LAKE FOREST, CA . � ' ':� � !:.� �i pw .�i CONTFL4CroR: SWAN POOLS.OF SOUTHERN CALIFORNIA License No. 440333' Phane: 949-859-6466 ' � - - Address: 24512 BRIDGER RDUnit: - - Cell: �� . -. . City/State: LAKE FOREST; CA . ZipCtltle 92630 ARCHITECT: � .. �..: LicenseNo... ..� . .. �� ... PHONE:. � EN INEER: � � � �� -� . ' License No. , � � PHONE ' CQMBINATION PERMIT'FEE SUMMARY Building Plan Check: . � � - . $287.46 Building Fees: $44225 Electrical Fees; $73.00 Mechanical Fees: � - - $41.50 Plumbing Fees: , � $114.50 SMIP Residential: ` - $3.00 SMIP Commercial: $0.00 TOTAL FEES: $961.71 "ReTer to fee receipts for all fees paid (or project '" , . � .l� NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 92-28, § 1, 72-21-92) � EXpIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. � IN$pECTIONS: In order for the work authorized under this permit to be wnsidered legal, such work must comply with all applicable'codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and fnal approval will result in the expiration of this permit. CODEt INSPECTIONIYPE UATE IN7ITIRL COUE;1 INSPELl10NTVGE DATE _ NI117UL5 761fi Fixed System Final Fire Prevention 11 206 Final MeChaniwl 1286 Pool Spa Final � 11� _� 208 Final Plumbing 200 Final Re-Roof 210 Final Electriwl 201 Fina! BbcWReta'm'rnq Wall 272 Final F'rte Prevention - ' 202 Final Factory Fire Plare 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final BuildinglOwupancy WORKERS' COMPENSATION DEC��TION;, I hereby aKrm under penalty of perjury one o( the following tleclarations: ❑ I have and will maintain a certificate of consent to sel(-Insure tor�workers' compensation, as provided for by section 3700 of the Labor Code, for the peAormance of ihe vrork for which this permit is issuetl. I have antl will mainlain worker5' compensalion insurance, as required by ' tion 3700 of the Labor Code, fw lhe peAormance of the work for which this pertnit is issuetl. My workers' compensation Insurance carrier antl policy number are: -A Carrier. NI � ��C- [r:Ci L`� (ihissecfion Crro/tbemmdetetlafnepermeis�aluet�EalonehvnCretldollars(310o)orlessJ Policy Number: ( �ioU�7 � 30✓ ❑ I certify tha� in [he pertormance of the work !or which Ihis permit is issuetl, I shall not employ any person in an manner so as to become subject to the vrorkers' compensation laws of omia, and agree that if I should become subj t to the vrork co nsation provisions of Section 3700 of the Labor , 4 (o ' c ply with these provisions m's5ignaWre ---�� WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNfAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLAFiS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, IMEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLFRATION: I hereby aRrm thal I am licensed under provisions of Chapter 9(commencing with Section 7000) of Division 3 of the Business and Professions Code, and my Ilcense is In full Force and effecl. �Lic. # ` � 3 Class # � % � 2 U onl rs5ignaWre 0 �e CONSTRUCTION LENDING AGENCY: ❑ I hereby aKrtn that there is a construclion lending agency tor the peAormance o( the work for wfiich this permit is issued. (Sec. 3097, Civil Cade). Lentler's Name: Lender's Atltlress: SignaWre Date OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty o( �erjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW fo� the following reason (Sec. 7031.5, Business and Pro(essions Code: My city or county which requires a permit to construct, alter, improve, demolish, or repair any sirucNre, pnor to its issuance, also requires the applicant for such permit lo (le a signed statement thal he or she is licensed pursuan� lo Ihe provisions of the Conhactors License Law (Chapter 9(commencing wilh Seclion 7000) of Division 3 of the Business and Professions Cotle) or [hat he or she is exemp[ therefrom and the basis for the alleged ezemption. Any violation of Section 7031.5 by any applicant (or a permit subjects Ihe applican[ to a civil penalty of not more Ihan five hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and [he stmcture is not intendetl or oRered for sale (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an ovmer of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not intended or oHered for sale. If, however, the building or improvement is sold vrithin one year of completion, the ovmer-builder will have lhe burden of proJing that he or she dld.noi build or improve (or purpose oS saleJ. ❑ I, as ovmer of the pmpertyi am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRAC70RS to construct the project (Sec. 7044, Business and Protessbns Code: Ttie contrectors License Law dces not apply to an owner of property who builds or improves thereon, and wfio cont2cis�for such project with a contractor(s) license pursuant to the C.ontractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: 305]d6(YO)) Owner ID verifed by dri�ense. ❑ Yes ❑ No Driver's License No. Expires: Verification of Ownership by (type of document, i.e. - property taR bill or deedj: DIVISION OF INDUSTRIAL SAFEN PERMIT CERTIFICATION: ' � ❑ I hereby certdy that no excavation frve (5) or more (eet in depth into wfiich a person is requiretl to descend, will be matle in connecibn with vmrk auttqrized by Ihis permil, and [hat no building siructure, scaHdding, falsework, a demolition or dismantling lhereof, will be more than thirty-siz (36) (eet high. (Chap. 32, Grp 2. Art 2. Sec. 341, Ttle 8, Califomia Atlminis[2tive Code). ❑ As owner-builder, I will not employ any0ne to do work which vrould require a permit from [he Division of Industrial Sa/ety, as noted above, unless such person has a permit to do such work from the division. Appliranfs SignaWre Division o/ Indus[rial Safely Permit Number: _ HAZ/1RDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will the applicant or present or fuWre building occupant need lo file and certify a Business Plan tor emergency response to release or threatened release of a hazardous matenal? ❑ Yes � No (Section 25505 0� the California Health and Safety Code requires, with some exceptions, lhat a Business Plan be filed with the Costa Mesa Fire DepartmeM by every business which has at any one time during a reported year a quantiry of hazardous materials equal to or greater than a weight o! 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard tempereture and pressure). 2. Does or will the applicant or present or future building occupan[ neetl b fle a registration form for acutely hazardous materials? ❑ Yes ❑ No (Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by each business which a[ any one time has on hand a quanti[y of acutely hazartlous matenals equal to or greater than a weight o/ 500 pounds, or a volume of 55 gallons, or 200 cubic feet o/ compressed gas at slandard temperature and pressure). 3. Does or will the applicant or present or NWre building occupant need lo prepare an RMPP (Risk Management and Preven[ion Program for acutely hazardous materials)? ❑ Yes ❑ No (Section 25534 of the Calitomia Heallh and Safety Cotle provides lha[ the Costa Mesa Fire Department may require the preparation, certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4. If an RMPP is presently required, has Section 25534 0! ihe California Heallh and Safety Code been fully complietl with? ❑ Yes ❑ No 5. Does or will ihe applicant or present or future building occupant require for the work which is the subject of this applicalion a pertnil tor such construction or modifcation from the South Coast Air Qualily Management DisMct or from any other air pollution control districl or agency? ❑ Yes ❑ No (Seclbn 658502 0( the Califomia Govemment Code requires that the requested infortnation be (umished on applications (a rwn-resitlential building pertnits). 6. Will any part of the facility to be constructed under Ihis permit be within 1000 feet from the outer boundaries of a school? ❑ Yes ❑ No Qf "yes", the laciliry musl meet the requirement o� Seclions 25534 and 42303 of ihe Cali(omia Health and Safery Code�. 7. If a permit fmm the South Coasl Air �uality Management District or other air polWtion contml district or agency is required for the work which is the subject of Ihis appliwtion, have all of the disclosures prescnbed by Califomia Health and Sa(e[y Code Section 42303 been made? ❑ Yes ❑ No 8. Qf'yes", atlach certificate ot wmpliance from the appropriate air pollulion wntrol afflcer). � - . CERTIFICA7E OF COMPLIANCE: I ceiti{y that under penalty_of perjury,�the informalion given above is correct. I agree to comply with all state.laws antl city ordinances regarding Hazardous Materials and Emissions: � SgnaWre - � Date' - CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:� I certify under penalry of perjury that I have read this application and state Ihat Ihe infortnation given is correcl. I agree to comply with all state laws antl ciry ordinances relating to building construction, and authorize represematives of the Cily of Cwta Mesa to enter upon the above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspectio . ignaWreo gal r � ale� y D An orA etlAppliranl Dale .o , , ., JobAddress: 2528 DUKE PL Suite: vicinity: Primary Occ: R3 Parcel Number: 14141248 Applicant CLAUDIO MATHOV Address: 8552 BOISE DR �\ �� Type of Construction: V-N � Zaning: Phone: 774.920.7857 HUNTINGTON BEACH, CA . Zip: 92646 owner STRICKLER, VERN M " Address 2528 DUKE PL � . � , Phone: 714-957-8003 COSTA MESA, CA . Zip: 92626 Contractor. FLOORING DESIGN AND CONSTRUCTION INC Address: 8552 BOISE DR � � ' � ' � Phone: 7i4.9207857 HUNTINGTON BEACH, CA Zip: 92646 - License: 857635 Arth : Address: Zip: Phone: License: Eng: Address: Status: ISSUED Applied: 01l09/2007 Issued: 03/OS/200� ISSUED BV: � Phone: License: SCOPE OF PERMIT • ADD 510 SF FAMILY ROOM TO (E) ONE-STORY SFD. INSTALL 2 NEW SKYl.IGHTS OVER THE DINING AREA AND RELOCATE 2 ADDITIONAL SKYLIGHTS IN (E) BATHROOMS. DEMOLISH PORTION OF EXISTING NON BEARING WALL BETWEEN THE LIVING'ROOM AND THE KITCHEN AND RELOCATE THE WATER HEATER. . - -- . _ i DESCRIPTIONR�VISED4l2/07. -� � �� -� �- � � � -� � � Plan Check: Permit: SMIP Res: SMIP Com: Other: Inspection: Total: $427.54 565775 $5.20 $0.00 50.00 $0.00 $1,090.49 SETBACKS MAINSTRUCTURE Front 0-0, , ACCESSORY � FroM 0-0 PARKING Existina: a Rear 32- 7 Rear 0- 0 Reauired: 0 FEE SUMMARY ' , Calc Valuation: „'� - Claim Valuation: � � PLANNING & ZONING .. left 0-0 . . Right �5,0� Lefl 0-0 � Right �- 0-0 - Proposed: 0 � 551,970.40 So.oO NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-27-g2) EXPIRATION: This permit shalt automatically expire and become wid if vrork is not commenced within 180 days, or it work is suspended or abandoned tor a period of 180 days. INSPECTIONS: In orqer for the work authorized under ihis permit to be considered legal, such work must comply with all epplicable codes, and all required Inspeetlons end finel epproval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CqL,L: (714) 7545626 wo-co law� WORKERS'COMPENSAnONDECLARAnON: I hereby eNirm under penalry of perjury one ot the following declarations: ❑ I heve end wlll malntain a cenificate ol consent m sell�lnsure lor workers' compensation, es provided br by section 3700 of the Lebor Cotle, for the pedormance of the work lor w�ich this pertnii is issued. � I have entl wlll mainWin workers' compensetion Insurance, es required by section 3700 of ihe Lebor Code, for the pertortnance of ihe woM for which this permit is issued. My workers' compensation Insuranca carner entl pollcy numbar ere: Carrier: ' Policy Numbec (This sectlon need not be cromp/efeC i! fhe peimit is velued af one hundred dollars ($100) oi /ess.J ❑ I certity Ihat in the peAormance ol the work tor which this pertnit is issued, I shall not employ any person In eny menner so es to become sub�ect to cha workers' compensation laws oi Califomla, and agrea t�at tl I shoultl bacome subJect to t�e workers' compensation pmvisions oi SecHon 3700 of the LeDor Code, I shall forthwith comply wilh these provisions. Applicant Slpnature: Date: WFRNING: FAILURE TO SECURE WORKEPS' COMPENSFTIqJ COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CPIMINAL PENALTIES PND CML FlNES UP TO ONE HUNDRED THOUSAND DOLLARE (S10p,000), IN ADDITION TO TME COST OF CAMPENSATION, pAMAGES AS PROVIDED WR IN $ECTION 3]W OF THE I.ABOR CODE, INTEREST, AND ATTORNEI"S FEES. LICENSED CONTRACTORS DECLARATION: I hareby eNirm that I em licensed untler provislons ot Chapter 9(commenr.ing with Sectlon 7000) of Dlvision 3 of Ihe Businass antl Professions Cotle, antl my license is in full force and aMecL Lla a Cless N Contractor's Signeture: Dete: CONSTRUCTION LENDIN� AGENCV: ❑ I hereby eflirtn [hat there is a consiructlon lending egenq for �he Oedortnance of the work for which Nis permit is issued. (Sec. 3097, Civil Cotle). Lenders Neme: Signawre: _ OWNER-BUILDER DECLARATIONS: Lentlefs Address: Date: 1 hereby eMirtn Ihat untler penalry of perjury thet I em E%EMPT FROM THE CONTRACTORS LICENSE LAW for ihe tollowing reason (Sec. �031.5, Busineu end Professions Cotle: Any ciry or counry which requires a pertnit to construct, alter, Improve, demolish, or repair eny strucWre, D�or to its issuance, also requires the epplicant for such pertnit to file e signetl stetement ihat ha or she Is Ilcensed pursuent to the provisions of the Contradors Llcense Lew (C�apter 9(commencing with Sectlon 7000) af Divislon 3 of t�e Business entl Professions Code) or thet he or she Is exempt theralrom antl the 6asis for the ellegetl exemption. Any violation of Section 7031.5 by any appliwnt for a pertnit subjects the epplicant to a civil penalry of not more t�en tive hundred dollers ($500).): ❑ I, as owner ot Ihe properry, or my employeas wi�h weges es ihelr sole compensa�lon, WILL DO THE WORK, end Ihe siructure Is nol intendetl or offered for sela (Sec. 7044, Business and Professions Code: The Contractors License Lew does not apply to an owner of properry who builtls or improves ihereon, entl who tices such work himsetl or hereelf or thmugh his or her own employees, provided that such impmvements are not Intended or oMered for sale. If, however, ihe builtling or impmvement is sold within one year ot completioq the owner-builder will have the burden of proving ihat he or she tlid not build or improve lor purpose of sale.). ' ❑ I, es ownar ol the pmperty, am EXCWSIVELV CONTRACTING WITH LICENSED CONTRAC70RS to wnstruct the project (Sec. 7044, Business antl Professions Cotle: The comractors License Lew tloes not eppty to en owner of properry who builCs or Imprwes thereon, and who contracts tor such project with a contraaor(s) license pursuant to iha Contractors License Lews.). ❑ I em ezempt under sec. eusiness and Protessions Cotle tor this reason: Signature: Date: Owner ID verified by dnvefs license. ❑ Yes ❑ No Driver's License No. Veniication ot Ownerehip Dy (type of tlocument, I.e. - properry tes bill or Ceetl): Expires: DIVISION OF INDUSTqIAL SAFETV PERMIT CERTIFICATION: ❑ I hereby certity �hat no exwve�ion five (5) or more leet In depth into which e person Is requlred to descend, will be metle in connectlon with work euthonzed by Ihis permit, and Ihat no building siructure, scaffolding, falsework, or demolition or tlismantling Ihereol, wlll be more ihen thirty-six (36) feet high. (Chep. 32, Grp 2, Art 2, Sec. 341, Ttle 8, Califarnla Administrative Code). ❑ As owneo-builder, I will not employ enyone to tlo work which would require a permit from the Division of Intlustriel Safety, es notetl ebove, unless such pereon has e permit t0 do SUCh wOrk irom the divi5lon. Signature: Date: Division ol Industnel Satety Pertnit Number: CERTIFlCATE Of COMPLIANCE AND AUfHORVi1710N OF ENTAY: I certify under penalry ol perjury that I hava read this application and state Ihat ihe information given is correct. I agree to Comply with all state lews entl ciry orCinances relating to building consiructlon, end euthorize representatives oi the Ciry ot Caste Mesa to enter upon the ebove-described pmperty for inspection puryoses. I egree not to occupy or ellow occupancy of eny building authorized by this permit until final inspection. Signature Ot Legal Owner(s) Date Antl/Or Authorized ApPliCent Date COUE 1. INSGECTIONTYPE 1616 Fixetl System Finel Fire Prevention 1266 Pool Spe Final 200 Final Re-Raof 201 Final BIocWRetaining Wall 202 203 Final Fectory Fire Place Final Sign 204 Final Demolition PAIE INIRIRLS rypF,Z msvecnoNrrve 206 Final Mechanical 208 Final Plumbing 210 Final Electrical 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final Building/Occupency QdIF 1t�EL5 JobAddr@ss: 2528 DUKE PL Suite: vicinity: ' Primary Occ: R3 Type of Construction: V-N Parcel Number: 14141248 Zoning: Applicam: CLAUDIO MATHOV Address: 8552 BOISE DR HUNTINGTON BEACH, CA Phone: 714.920.7857 Zip: 92646 Owner: STRICKLER, VERN M Address 2528 DUKE pV � � . � • Phone: 714-957-8003 COSTA MESA, CA Zip: 92626 Contractor. ' FLOORING.DESIGN�AND CONSTRUCTION INC Address: -�-8552 BOISE DR, '��.: " � 'G�"�. ,-`� Phone: 714.9207851 , i:c, , HUNTINGTON BEACH, CA Zip: 92646 ��- - License: 857635 Arcfi : Address Zip: Phone: License: Eng: Address: ISSUED BY: Status: ISSUED Applied: 01/09/2007 " Issued: 03/OS/2007 Phane: License: �� : � � SCOPE OF PERMIT � ADD 477 SF FAMILY ROOM TO (E) ONE-STORY SFD. INSTALL 2 NEW SKYIIGHTS OVER THE DIN7NG AREA AND RELOCATE 2 ADDITIONAL SKYLIGHTS IN (E) BATHROOMS. DEMOLISH PORTION OF EXISTING NON BEARING WALL BETWEEN THE LIVING ROOM AND THE KITCHEN AND RELOCATE THE WATER _ HEATER. . _ _., _ . - . FEE SUMMARY Plan Check: $427.54 Permit: 5657.75 SMIP Res: $5.20 ', SMIP Com: 50.00 Other: �0.00 I nspection: 30.00 Total: $1,090.49 . _ ��,. . � �� SETBACKS MAIN STRUC7URE Front, � 0- 0 ACCESSORY . , Front �0-0 � � PARKING � , Exislina: � a � Calc Valuation: ssi,e�o.ao Claim Valuation: So.00 �� . � i = �i' Rear 32• 7 Rear 0- 0 Reauired: 0 PLANNING & ZONING Left 0- 0 Right -. 5- 0 Lefl 0-0 � Right 0-0 � Pr000sed: 0 � � �� NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements untler Calitornia statutes and related regulations. (Ord. No. 92-28, § 7, 12-21-92) EXPIRA710N: 7his permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned tor a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and required Inapectiona and finel approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this p FOR INSPECTIONS CALL: (714) 7545626 244&6fi (6/00) WORKERS'COMPENSAnON DECLARAnON: I hereby affirm under penalry of perjury one oi ihe following declarations: � ❑ I have antl will mainlain a certifiwte of consen� lo sell-Insure for workers' compensation, es provided for by section 3700 ot �he Labor Cotle, for �he pehormanCe of the otl�for which tpis permi[ is issued. �, :_ �LhA and witl maimain workers' compensation insurance, as required by section 3700 of the Labor Code, for the pedortnance of the work for which ihis pertnit is issuetl. o�jcers' compensation Insurance carrier antl policy number are: 6arne.,: 51/k i i; I'd �I✓ aa��yN�m��: -, � I�J � i'o�Q �O6 is secfion need no( be campletetl i! the p it is veluetl at one huntl�etl dollers ($100) or Iess.J ❑ I certify that in tPe pedormance of t ork for which this permit is issued, I shall not employ any person in eny manner so as to become subject to Ihe workers' compensation laws of Californie, a e th t'if I should become sublect ro the workers' compensation provisions of Section 33700 of the Labor Code, � shell forthwith _ comply with these piovisions. ?�� /' I� r YA6Q4�' .<gqature`_ � Date: � . .±�' � yjiA1NNO"FAILURE T05ECUfiE WORK S MPENSATION CAVERAGE IS UNLAWFUL AND SHALL SUBIECT AN E TO CRIMINAL PENALTI AND CIVIL FlNES UP TOIXJE HUNDRED TFIOUSANO DOLLAPE �$100.000),IN AD ITION TOTHE COST OFCOMPENSATION, DAMAGES AS PROVIOED F9R IN SECTIIXJ 3]O60F THE L4BOR CODE, INTEREST, ANDATiORNEY'S FEES. UCENSED CONTRACTORS DECLARATION: (commencing with Section 7000) of Code, antl my license is in full CONSTRUCTION LENDING AGENCV: ❑ I hereby attirm �Pat ihere is a construction lending agency for ihe pertormance of the work for which this permit is issued. (Sec. 3097, Civil Code). Lentler's Name: Lender's Address: Signatura: OWNEFi-BUILDER DECLARATIONS: Date: I hereby eHirm Ihet under penalty ol perjury ihat I am EXEMPT FROM THE CON7RACTORS LICENSE LAW for the foliowing reason (SecJ03L5, eusiness and Professions Code: Any ciry or county which requires a permit to consimct, alter, improve, demolish, or repair any siructure, prior b its issuance, also requires ihe applicant for such permit to tile a signed statement that he or she is licensed pursuant to the pmvisions of the Contractors License Ww (Chapter 9(commencing with Section 7000) o� Division 3 oi the Business antl Professions Code) or ihat ha or she is exempt therafrom and the basis for the alleged exemption. Any violation of Section 7037.5 6y any applicant for a parmit subjects the applicant ro a civil penalry oi not more than five hundred dollars ($500).): ❑ I, as owner ot t�� p�operty, or my employees with wages as their sole compensation, WILL DO 7ME WORK, and the siructure is not intendetl or oNered tor sale (Sec. 7044, Business and Professions Code: The Coniractors License Law does not apply to an owner of property who builds or impmves ihereon, and who dces such work himself or herself or through his or her own employees, providad that such impmvemems are not intended or otteretl for sale. If, however, the building or improvemem is sold within one year of completion, the owner-builder wiil have ihe 6urden of proving that he or she did not build or improve for purpose of sale.). ❑ I, as owner of lhe pwperty, am EXLLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to consiruct the pmject (Sea 7044, Business and Pmfessions Cotle: 7he contractors License Law does not apply to an ownei ol propeny who 6uilds or improves thereon, and who coniracls for such pmjeci with a coniracror(s) license pursuant �o iha Contractors License Laws.). ❑ 1 am exempt under sec. Business antl Pmtessions Code /or this reason�. Signature: Date: Owner ID venfietl by tl��er's license. ❑ Yes ❑ No Driver's License No. Verifica�ion ot Ownersqip by (typa ol documen�, i.a. - property tax bill or deetl): Ezpires: DIVISION OF INDUSYR�A� SAFETY VERMIT CERTIFICATION: ❑ I here6y certify iPat no eacavetion tive (5) or more feat in depih into which e person is required to descend will be made in connection wi�h work authorized by this permit, and that Po builtling structure, scaffolding, falsework, or demolition or dismantling thereof, will be more than thirty-siz (36) feet high. (Chap. 3.2, Gry 2, An 2, Sec. 341, Title 8, Californie Adminisirative Code). ❑ As owner-huildet, I will not employ anyone to do work which would require a permit from ihe Division of Industrial Satety, as noted abova, unless such person has a permit to do sucn work irom the division. SiqnaNre: Date: Division of Industrial Saiery Permit Number: CERTiFICA7E OF CO M10E AND AUTHORIZATION OF ENTRY: I cenify untler penalry of perjury ihat I have read ihis application and state Ihat �he intormation given is correct 1 agrea to co with all state laws and city ordinances relating to building consWction, antl authorize representatives of the Ciry of Costa Mesa to enter upon Ihe above-descnbed prop y�pnspection purposes. I egree not b occupy or allow acupancy of any builtling authorizad �y ihis permit until final inspection. COOE �. INSPECTION TVP� 1616 Fixed System Final Fire Prevention 1266 Pool Spa Final ' 200 Final Re-Rooi 201 Final8lock/R9�ainingWell/ 202 �. Final Fac�ory Fire Place 203 Firial Sign 204 Final Demolition SODE� INSPECTIONiVPE 206 Final Mechanical 208 Fi P g 21� Fin ElectriCal 21 Final ire Preventio 2 Fi p o�al 2 al5ita 250 Final Builtling/Occupancy AT INTRIALS JobAddress: 2528 DUKE PL Staws: ISSUED ,. Suile No Applled: 05/15/2007 Vicinity: Issued: 05/15/2007 Parcel Nunmber: Applicant: Address: 14141248 CLAUDIO MATHOV 8552 BOISE DR Phone: 714.920.7851 HUNTINGTON BEACN,-CA, - Zip 92646 owner STRICKLER, VERN M Address 2528 DUKE PL � � - i i _ . . � . �Phone:� � .. . COSTA MESA, CA,�,.� .�- � - Zip: 92626 �� i � � j; ;; , � Comractor FLOORING DESIGN AND CONSTRUCTION INC Address�. 8552 BOISE DR , . . , Phone:� 714.9207851 HUNTINGTON BEACH, CA Zip: � 92646 � ' License:857635 ISSUE FEE Temp service test Res. a/c package New Res (7-2 units) New Res (3+units) Pool / Spa Lighting Fixts - Recept Outlets . Switches Non Res Appl Res Appl Service to 200a � Service to 1000a Service over t000a � Motors to 1 hp � Motors to 10hp Motors to 50hp Motors l0 100hp Molors over 100hp Communiwtion drops Sub panel to 200a Pole Light Pkg Sign Circuits Temp Pwr Pole Intermed Pole ISSUED BV: ' �� ' ' " SGVYt Vh YtKMII ADD 510 SF FAMILY ROOM TO (E) ONE-STORY SFD. INSTALL 2 NEW SKYLIGHTS OVER THE DINING AREA AND RELOCATE 2 ADDITIONAL SKYLIGHTS IN (E) BATHROOMS. DEMOLISH PORTION OF EXISTING NON BEARING WALL BETWEEN THE LIVING ROOM AND THE KITCHEN AND RELOCATE THE WATER HEATER.�REF:: B07-00029 � � ' ELECTRICAL INCLUDESt 1 RES A/C UNIT-21 LIGHT FIXTURES, 16 OUTLETS, 13 SWITCHES AND 1 SERVICE TO 200 AMPS. � ' �` � � � , $23.50 50.00 554.50 $0.00 50.00 , �0.00 $2273 517.60 57a.30 $0.00 50.00 530.50 , $0.00 50.00 $0.00 ` . $0.00 50.00.' � $0.00' . $0.00 50.00 $0.00 $0.00 $0.00 $0.00 $0.00 FEE SUMMARY Quantity � Qvantity � --- - - - _ � --- - =Temp�DistSystem /-Lighting-- $OAO 0 ' - � � . � Busway /] 00 k � � - 50.00 0 -' Standing Section $0.00 0 ; � 0 MiscElectricaPEquipment $0.00 0- � " 0 Transformers up to 1 kvalkw ' S0.00 0�, � 0 ......_........uptol0kva/kw $0.00 ,"0� - 21 ..., :.*. -. � ;...........up to 50 kva/kw $0.00 . 0' � � . 16 , � ......... .....up to 100 kva/kw $0.00 , 0 ..- :: . � �..: 13 �� '- � � .............:�:..over,100kvalkw $0.00'<' 0 � 0 _ � - � Low Voltage Equipment $0.00� � 0 " -• 0 . ' Low Volt Wiring5ysleml.'CkL-: -' 50.00 � 0� 1 . Misc. Conduit � -= $0.00 - 0 ' 0 ' � " �MisaConductor % 50.00',�� 0 . . 0 � . Circus ( gen or ride) " , � SQ00 � ;� 0 ,0 , `.; , � 'Circus (mech ride or�lights)�- ,, 50.00 '. • '0 .� -� , 0 - � - ,' ChristmasTreeStand " ' ^$0.00"i 0�. � 0 - � �Pireworks Stand ' �� $0.00 i' 0 - 0 �� , Other Eledrical Fee ' ; $0.00 �- , . _0 ' . . . _ _ ... ,. . 0 � InyestigationFee� - � $0:00' -0 Plan Check Fee � � . =, $0.00 . 0 - � 'Reinspection Fee - - ' $0.00 0 0 � TOTAL CALCULATED FEES $163.13 0 COMMENTS / SPECIAL CONDITIONS NO710E: The work authorizad by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit�shall automatically expire and become void if work is not commenced within 1 BO days, or if work is suspended or abandoned for a period ot 180 days. - INSPECTIONS: In order for the work autho�ized under this permit to be considered legal, such work must comply with all applicable-cod nd all required Inspections and final approvel must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 ' 2648-66(N00) WORKERS' COMPENSATION DECLARATION: � I hereby attirm under penalry of perjury one ot the following declarations: ❑ I have antl will maintaln a cenificate of consent to setl-Insure for workers' compensation, es provided for by section 3700 of Ihe Labor Code, for the pertormance ot the work for which Ihis pertnit is issuetl. .0 _I.have entl will maintain workers' compensation insurance, as required section 3700 ot [he Lahor Code, for the pertortnance of the work or which this pertnit i issued. M workers' c sation Insure a carn lic number are: /x-r/ �O , �CarrierY- � ��—��'� Policy.Number: � U .(TAis�sec(ion need notb�omplete i( the permit is �'dlued ef one hundred dollers ($100) or /essJ ❑ I cenity that in the peAorm , e of ihe work for which ihis pertnit is issued, I shall not employ any person in any manner so as to bewme subject m the workers' compensation laws of Cal' o ia, d a ea that if I should become su6�oct to Ihe workere' compensetion provisions of Section 377700 of the Labor Cotle, I shall forthwith comply with ihese provisi � �' �� \ ApDlicant Signature: Date:— - (9 1 .WARNWGFAILURETOSECUR W (ERS'CAMPENSATIONCOVERAGEISUNLAWFULANDSHALLSUBJECTANE OYEPTOCRIMINALPEN TIESA DCIVILFWESUPTOONEHUNDRED TMOUSANDOOIJ.ARE(5100, �,INNODITIIXJTOTHECOSTOFCOMPENSATION,DAMAGESASPROVIDEOFORINSEGTION3]OGOFTHEL4BORCADE,IMEREST,ANDATTORNEV'SFEES. LICENSED CONTRACTORS DECLARATION: I hereby aHirtn ihat I am I force�and e8ect Lic. p � CoM�actorls Signatuie: : Chapter 9(commencing with Section 7000) of Division 3 oi Ihe Business and Code, and my license is in full CONSTRUC710N LENDING AGENCV: ❑ I hereby affirtn ihat ihere is a construction lentling agency for ihe pedormance of the work for which ihis pertnit is issued (Sea 3097, Civil Code). Lendefs Neme: Lentler's Adtlress: Signature: OWNER-BUILDER DECLARATIONS: Da�e: I hereby eNirtn ihat under penalty of perjury that I am EXEMP7 FROM TME CONTRACTORS LICENSE LAW tor ihe following reason (Sec. 7031.5, Business and Professions Code: Any ciry or county which reQuires a permit to consiruct, altar, impmve, demolish, or repair any simcture, prior to its Issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuent lo the provisions ot ihe Contractors License Law (Chepter 9(commencing with Saction 7000) of Divislon 3 of the Business and Profeuions Code) or ihet �e or she is exempt therefrom and the basis tor the alleged exemption. Any violation of Section 7031.5 by any applicant for a pertnit su6jecis ihe applicant to e civil penalry of not more than tive �untlretl tlollars ($500).): ❑ I, as owner of the propeny, or my employees with wages es iheir sole compensation, WILL DO 7ME WORK, and the structure Is not intended or otteretl tor sale (Sec. 7044, Business antl Professions Code: The Contractors License Law dces not apply ro an owner of properry who builds or impmves thareon, and who dces such work himself or herself or through his or her own employees, provided Ihat such improvements ere not intended or oHered lor sale. It, however, Ihe builtlinq or improvement Is sold within one year of completioq Ihe owner-builder will have the burden of proving that he or she did not build or improve tor purpose ot sale.). � ❑ I, as owner oi tha property, am EXCLUSIVELV CONTRACTNG WITTi LICENSED CONTRAC70RS to construct tha pmied (Sec. 7044, Business and Professions Code: The contractors License Law tloes not apply to en owner ol property who builds or Improves thereon, end who contracts for such project with a contractor(s) license pursuant to Ihe Coniractors License Lews.). ❑ I am exempt under sec. Signature: Owner ID verified by drivels license. ❑ Ves ❑ No Business and Professions Code tor this reason: Verification of Ownership by (rype ot dxument, i.e. - property tez bill or deetl): DIVISION OF INDUSTRIAL SAFE7Y PERMIT CER7IFICA710N: Driver's License No. Date: Expires: ❑ I here6y ceriity that no excavetion five (5) or more teet in tlepih Into which e person is requirad to descand, will be made in connec�ion with work authonzetl by Ihis pertnil, and �ha� no building strucwre, scaHolding, falsework, or tlemoli�ion or dismantling Ihereof, will be more Ihan Ihirty-six (36) feet high. (Chap. 32, Gry 2, Ah 2, Sec. 341, Title 8, Califomia Atlministra�ive Code). ❑ As owner-builder, 1 will not employ enyona to tlo work which woultl require e permit from the Division of Industriel Sefety, es noted ebove, unless such person has e permit to do such work from Ihe division. SignaWre: Dare: Division of Industnal Safety Permit Number: CERTIFlCATE OF COMPLIANCE D A ORIZATON OF EMRY: I certify under penalty ol perjury iha� I have reatl this application and state ihat Ihe intormation given is correct. I egrae to comply with all ate la and ciry ordinances relating to building consiruction, antl authonze representatives of Ihe Clty of Costa Mesa to enter upon Ihe ebove-descnbed property for insp tion p �ses. I agree not to occupy or allow occupancy of any building authorized by this permit until tinal inspaction. CODE t. INSPECTION TYPE 1616 Fixed System Final Fire Prevention 1266 Pool Spe Final 200 Final Re-Raof 201 Final8lock/Retaining Well 202 203 FIneFFacrory Fire Place Finel Sign 204 Flnal Demolition P�g I�Il�LS COpE I INSPECTION TYPE 206 Final Mechenical 208 Final Plumbing 210 Final Electrical 212 Final Fire Prevention 220 Final Plenning Approval 222 Flnel Site 250 Final Building/Occupancy (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 2528 DUKE PL Suite No Vicini�y: Parcel Number: 74141248 Appticant: CLAUDIO MATHOV Address: 8552 BOISE DR _ HUNTINGTON BEACH; CA ownec .STRICKLER, VERN M Address: " 2528 DUKE PL . � � .' COSTAMESA,-CA' � � MECHANICAL PERMIT Phone: 714.920.7851 , Zip: - 92646 � , Phone: Zip: 92626 Contractor. FLOORING, DESIGN AND CONSTRUCTION INC . Address:� 8552 BOISE DR Status: ISSUED Applied: OS/15/2007 Issued: 05/15I2007 ISSUED BY: '� . Phone: 714.9207851 , �, HUNTMGTON BEACH, CA � Zip: � 92646 � ". License:857635 � � � � . �"� � SCOPE OF PERMIT � � � ADD 510 SF FAMILY ROOM TO (E) ONE-STORY SFD. INSTALL 2 NEW SKYLIGHTS OVER THE DINING AREA AND RELOCATE 2 ADDITIONAL SKYLIGHTS IN (E) BATHROOMS.. DEMOLISH PORTION OF EXISTING NON BEARING WALL BETWEEN THE LIVING ROOM AND THE KITCHEN AND RELOCATE THE WATER HEATER. REF.: B07-00029 , � � MECHANICAL INCLUDESi 1 FAU < t00K BTU, T REPAIR/ALT COOLING/HEAT AND 1 ,. � � � � COMPRESSOR/ABSORPTION�SYSTEM UP TO 3 HP. . �: ' �� ' � , . , FEE SUMMARY . . . - � Quantity , � Quantiry ISSUE FEE $23.50. ' � � � � � � Repair / Alt Absorbtian Unit � � $0.00� 0 � � Inst FAU <100 k BTU ' $14.80" ' 1" ' -" ' "—" ` � `�,, �'Repair I Ait Refiigeration Unit $0.00 0 Insl FAU >100 k BTU 50.00 � 0 - � Ventillation System � $0.00 0 Repair/Alt Cooling/Heat 51370 1 Evap'oiativeCooler �- $0.00 0 � Insl I Rep, Recess Wall Htr $0,00 0 Commercial Incinerator , �$O.OP-,'0 , � Refrig Sys <100 k BTU • 50.00 0 Domestic Incinerator 'i � r 150.00 � 0 , Refrig Sys >100 k BTU 50.00 0 Compressors / Absomtion Svstems '��. � Gas Piping $0.00 0 �� -� ':��; Up to 3 hp / 100 k BTU . $0.00 0� Factory Fireplace - ' 50.00 0 '3 To�t5 hp / 500 k BTU ' �$0.00 �0 Hood wlMech Exhaust � SQ00 0 ' �`� . 15 �To 30�hp./ 1,000 k BTU - � $Q00 0 VAV Box � 50.00 0 ., . � <, 30 To 50 hp'/.1,750�kBTU - � $0.00, ' �0 Vent Fan / Single Duct' ' $0.00�� -0 - � - � " --� Over 50 hp-/ OJer 1;750�BTU �- - � $0.00 / 0 Appliance . $0.00 0 - . ,. - ; Boilers - 'ii Fire Dampers � 50.00 0 ' , , `Up to 3 hp . ,.;= / , / � ,$1470 1 Smoke Dampers , ' , $Q00 .� �0 _ � � � . . � 3 To 15 hp �" , ', � . -$0.00 0 Insl or Relocate Appl Vent , $0 00 0`.�- � - � _`�1510 30 hp - . � � � " �, �$Q00 0 Air Handiers < 10000cfm;.` �� SQ00 �� 0 � - � - -'- - 3010 50 hp � � S �• -, A ;. � �., �i $0.00 0 Air Handlers > 10000cfm � � ��50_00 0 - _ � � . Over 50 fip , i ; � 50.00 0 Floor Furnace - - $0.00. " 0 - , , Other Mechanical Fee , • " % Floor or Suspend Heater 50.00 0 . ' �" � Investigation Fee , $0.00 � � -� , � Plan Check Fee � , , 50.00 . �� , „ � Reinspection Fee- - ,. 50.00 -- . � -- . - �" � TOTAL CALCULATED FEES 566.70 COMMENTS I SPECIAL CONDITIONS NOTICE: Tha work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced wi�hin 1 BO days, or if work is suspended or abandoned for a penod of 180 days. INSPECTIONS: In order for the work authorizad under this permit to be considered legal, such work must comply with all applicable required Inspectlone and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of FOR INSPECTIONS CALL: (714) 7545626 244&48 (8/00) WORKERS'COMPENSAnON DECLARAnON: � I hereby aHirtn untlar penalty ol perjury one of the following tleclarations: ❑ I have and will maintain a certificate of consent to self-Insure for workers' compensation, es pmvidad for by section 3700 of Ihe Labor Code, for the pedormance of ihe work for which this permit is issued. wiil insurance, esreq �il�olicv num6er not be complered i! Ihe permit is v6luetl at one section 3700 ot the Labor Code, for the peAortnance of the� for wh� this�ssuetl. 1 � POIICy.Numbef:_ � Ilars ($100J orless.J � I certify ihat in �he perforn a ce of the work for which this pertnit is issued, I shall not employ any person in any manner so as to become subiect to the workere' compensation laws oi C I rnla, end egree ihat ii I should become subject to ihe workers' compensation provisions of Section 37 0 of the Labor Code, I shall forthwlih comply.with ihese provi . r }- Applic iSiqnawre: � /1� �--Date:" � �'� J �% / WARNING FAILURE TO SECU j ERS' CAMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOVEF TO CRIMINA� PENALTIES ANO CIVI� FINES UP TO qJE HUNDRED THOUSAND DOLLARE ($100,OW), IN AODITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTIIXJ 3]O60F THE LABOq CADE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I �ere6y aHirtn that I am force and.ettacL Lic. q _ Contrecrors Signature: 9(commencing with Section 7000) ot Division 3 ot the Business a^� Professions Code, and my license is in full Class q � 1 ! . oe�e_— ; � f lrl CONSTRUCTION LENDING AGENCY: ❑ I hereby aflirm ihat ihere is a construction lentling agency for the performance of ihe work for which ihis permit is issued. (Sec. 3097, Civil Code). Lenders Name: . Lendefs Address: Signeture: OWNER-BUILDER DECLARATIONS: Date: I hereby aHirtn t�at untler penalty of perjury Ihat I em EXEMPT FROM THE CON7RAC70R5 LICENSE LAW tor Ihe following reason (Sec. 7031.5, Business and Professions Code: Any city or counry which requires a permit to constmct, elter, improve, demolish, or re0eir any stmcture, pnor to its issuance, elso requires the applicant for such permit ro tile a signed statement that he or she is licensed pursuant to the provisions ot the Contrecmrs License Ww (Chepter 9(commencing with Section 7000) of DlNslon 3 of ihe Business and Protessions Cotle) or that he or she is ezempt therelrwn end ihe basis for the allaged ezemption. Any violetion of Sectlon 7031.5 by any applicant for a pertnit sublects the epplicant lo a civil panelry of not more ihan five huntlretl tlollars ($500).): ❑ I, as owner of ihe propeny, or my employees with wages es their sole compensation, WILL DO THE WORK, end the structure is not intended or oHeretl for sala (Sec. 7044, Business and Professions Code: The ConVactors License Law dces noi apply to an owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provitletl ihet such improvements are not intended or oRered for sale. If, however, ihe building or improvemen� is sold within one year of completion, the owner-builder will have Ihe burden of proving Ihat he or she did not build or improve for purpose of sele.). • ❑ I, as owner of the property, em EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business antl Professions Code: The comrectors License Lew does not apply to an ownar of properry who builds or impmves thereon, end who contracts br such pmject with a concractor(s) license pursuant to the Contradors License Lews.). ❑ I am exemp� under sec. Business and Professions Code for ��is reason: Signature: Date: Owner ID verified by dnvefs license. ❑ Ves ❑ No Drivefs License No. Verifitation of Ownership by (lype of document, i.e. - property tex bill or deed): Expires: DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certity ihat no excavation five (5) or more feet in depth into which e person is required to tlescend, will be made in connection with work euthonzed by this pertni�, antl �hat no builtling StNCNre, Scafloltling, falsework, or tlemoliti0n Or tlismantling thereoi, will be more lhan lhirty-Six (36) teet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Ttle 8, Calilornia Atlministrative Code). ❑ As owner-builder, 1 will not employ anyone to do work which woultl require e pertnit from the Division oi Intlustrial Safery, as noted ebove, unless such person hes a pertnit to do such work irom the diNsion. Signature: Date: Division of IntlusMal Safety Pertnit Number: CEHTIFlCATE OF COMPLIANCE AND UTHORIZATON OF ENTFiV: I certify untler penalry of perjury ihat I have read ihis application and state that the infortnation given is correcL 1 agree to comply with all slat ws and ciry ordinances relaling to building consWcfion, and euthonze representatives ot the Ciry ot Casta Mesa to entar upon the above-descnbetl propeM �or inspecti ur�ses. I egree not to occupy or allow aapancy ot any building authorized by this pertnit until final inspection. COUE I, INSPECTIONTYPE 1616 Fized System Final Fire Preventlon 1266 Pool Spa Final 200 Finel Re-Roo� 201 Finel Block/Retaining Well 202 Final Factory Fire Place 203 204 FinalSign � Finel Demoiiiion Q�g �a� CODEI INSPECTIONTYPE �� j�,¢,,,,� IMRI�lS 206 Final Mechanical �� 208 210 212 220 Final Plumbing Final Electrical Finel Fire Preveniion Final Planning Approval 222 Flnal Site 250 Final Building/Occupency (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.��uUMBING PERMIT n FAIR DRIVE, COSTA MESA, CA 92626 . JobAddress: 2528 DUKE PL Status: �SSUE� Suite No Applied: OS/15/20W Issued: OS/15I2007 Vicinity: Parcel Nunmber: 14141248 applicam: CLAUDIO MATHOV Address: 8552 BOISE DR HUNTINGTON BEACH, CA. Owner: , STRICKLER, VERN M Address , 2528 DUKE PL , i � ' "' COSTA MESA, CA, �� - Phone: 714.920.7851 , Zip: 92846 Phone: Zip: 92626 Contrector:� FLOORING DESIGN AND CONSTRUCTION INC Address: � 8552 BOISE DR . HUNTINGTON BEACH, CA ; Phone: �714.920.7851 . � Zip: 92646 �. , .License: 857635 ISSUED BY: SCOPE OF PERMIT ADD 510 Sf FAMILY ROOM TO (E) ONE-STORY SFD. INSTALL 2 NEW SKYLIGHTS OVER THE DINING AREA AND RELOCATE 2 ADDITIONAL SKYLIGHTS IN (E) BATHROOMS. DEMOLISH PORTION OF EXISTING NON BEARING WALL BETWEEN THE LIVING ROOM AND THE KITCHEN AND RELOCATE THE � WATER HEATER. REF.: 807-00029 0`�. � -/ � -'� � �- . � -� - � ` �� • PLUMBING INCLUDES: 1 WATER HEATER. ISSUE FEE Back9ow irrigation Backflow Preventer Bathtub Clarifier System Connect (Ice,Soda,etc) Dental Units ' DiShwashe� Drain, Floor Drain, Rainwater Drain, Roof Drinking Fountain Expansion Tank Gas Earthquake Valve ��. Gas (1-a outlets) � Gas (Over a outlets) - Gas Repipe Gas Service Interceptors (Grease, Oil) Interceplors (Santl Auto ) AMT QN . 523.50 50.00 0 $0.00 0 50.00 0 S0.00 0 $0.00 0 $0.00 0 50.00 0 $0.00 0 $0.00 0 i - 50.00 0 80.00 0 150.00 0 $0.00 ,�, -0� � $0.00" � � 0' �� $0.00 � 0 � 50:00 0_� � 50.00 0 so.00 0 so.00 0 � FEESUMMARY - _ �� -- �, . _ --'nMT � �arv _� � Laundry Tub / Washer 30.00� 0 - Sump Pump - Landscape Irrigation 50.00 0 Swimming Pool ;- P-Trap %$0.00 0 , Trap Primer - Pressure Regulator �, 50.00 0 Urinal '' ' , Process Piping (per 10 ft) �$0.00 0 Vacuum Brkr Bkflow(1-4) Receptors 50.00 0 Vacuum Brkr Bktlow(5+) . SepticTank��'��? ' ��.:$0.00 0 WashBasin �� SewerCapforDemo '50.00.,_ 0 WashBasinSet Sewer Connect � 50.00 ^ 0 Waste and Vent System Sewer Private Line .. " $0.00 : Oi , �c �'^'- Waier Closet (Toilet) � Shower -� � ' - 50.00 0�� - Waler Heater I vent Sink, bar � -� '�� SOAO � 0 . VJaler Piping (Inst or Rep.) - Sink, commeicial � - $0:00 0 ", � .- Wate%Re-pipe� �C i �� Sink, Floor - � - 80.00 -0 - Water�Service �';� / Sink,kitchen . � 50.00 � 0. �� ;WaterSoftener � / Sink, service/mop � $0.00 0 �� OTHER � � � Spa (private) � $0.00 0 � � VIOLATION / Spa (public) -` � - . 50.00 `. 0 � � ' PLAN CHECK _ � � , . ; REINSPECTION ' - ' TOTAL CALCULATED FEES' COMMENTS I SPECIAL CONDITIONS , AMT 50.00 50.00 $0.00 50.00 50.00 $0.00 $0.00 50.00 §0.00 $0.00 $12.30 $0.00 50.00 $0.00 50.00 $0.00 $0.00 30.00 50.00 535 80 on 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 C NO710E: The work authorized by ihis permit shall compty with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 9248, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a perial of 1 BO days. INSPECTIONS: In order for ihe work authorized under this permit to be considered legal, such work must comply with all applicable codes,-end.all requlred inspectlona end final approvel must be obtained. Failure to obtain inspections and final approval will result in the expiration of this�permit. FOR INSPECTIONS CALL: (714) 7545626 �/ 2aase6 f5iool WORKERS'COMPENSAnONDECLARATION: � � I hereby affirm under penalry of perjury one ot the following tleclerations: ❑ I hava end will maintain a certiticate ol consent to self-Insure for workers' compensatlon, es provided for by section 3700 of the Labor Cotle, tor the peAormance of the work for which Ihis permit is issuetl. ��_ I have end will maintain workers' compensation insurance, es requiretl b� section 3700 of Ne La6or Code, for the peAortnance of Ne vroAc fa whkh this pertnl't is issued. My workers' compen s rance ner and ber are: ��+ �� Carrier: • CPplicy _Number. � "J I �(Ihls section need not be tomp/ete i the permit is valued et one hundred doflare ($100) or less.) ❑ I ceniy Ihat in the performan of ih w for which this permit Is issued, I shall not employ any person in eny manner so as to become subleci �o the workers' compensation lews of Calito , n ree that If I s�ould become suDject to Ihe workers' compensetion provislons of Section 3700 of ihe Lebor Cotle, I shell forthwilh comply with these provision . ApplicentSignature: �Dete: \ � �� WARNIN(3: FAILURE TO SECURE ORKERS' CAMPENSATION CAVERAGE IS UNLAWFUL ANO SHALL SUBJECT AN EMPLOVER TO CRIMINAL PENAL IES AND CIVIL FINE$ UP TOONE HUNDRED i110USAND DOLIARE (5100.000), IN ADDITIIXJ TO THE COST OF COMPENSATION, DAM4GES A$ PROVIDE� WR IN SECTION 3708OF THE IABOR CODE, IfJrEREST, AND NTTORNEY'S FEES. LICENSED CONTRACTORS DECLARA710N: I hereby.aMirm Ihe1 I em 11 �under mvisi s ot Chepter 9(wmmencing with Section 7000) ot Divlsion 3 oi Ihe Business antl Professions Cotla, entl my license is in full lo�ce ane eHect. Lic. N J r Class A C -- O ConiractofsSignaWre: // �Deta: - � / � � _ CONSTRUCTON LENDING AGENCY: ❑ I here6y eHirtn Ihat there is e construction lentling agency tor Ihe pertormance ot the work for which thls permit is issuetl. (Sec. 3097, Civil Code). Lentler's Neme: Lender's Adtlress: Signatura: Date: OWNER•BUILDER DECLARATIONS: I hereby e%Irtn thet untler penelty of perjury Ihet I em EXEMPT FROM TME CONTRACTORS LICENSE LAW for the following reason (SecJ031.5, Business entl Professions Code: Any ciry or wunry which requires a permit to constmct, elter, improve, demolish, or repair any siructure, prior to its issuance, also requires ihe epplicant tor such permit to lile e signed statement Ihat ha or she I5 Ilcensed pursuant to the pravisions of ihe Contrectors License Lew (Chapter 9(commencing with Sectlon 7000) of Divislon 3 of Ihe Business flntl Professions Coda) or that �e or she is exempl therelrom entl tha basis br the alleged evemption. Any violation of Section 7031.5 by any applicant tor a pertnit subjects the epplicent to a civil panalry W not more �hen tive hundred dollers ($500).): ❑ I, es owner of Ihe property, or my employees wlih wages es their sole compensation, WILL DO Tl1E WORK, anC Ihe siructure Is not intended or oHeretl for sale (Sec. 7044, Business and Professions Code: The Contractors License Lew tloes not appty to an owner ot propeM who builds or improves thereon, antl who Coes such work himself or hereelf or through his or her own employees, proviAetl thet such improvemems ere not imentlatl or oHered tor sale. It, however, Ihe building or improvement is sold within one year of completion, ihe ownerbuiltler will have the burden of provinq Ihat he or she did not build or improve tor purpose of saleJ. ' � I, as owner ol the property, em E%CLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business end Prolessions Code: The comrecrors License Law tloes not epDh' �o en owner oi property who builds or impmves thereon, end who contracts tor such prqect wlih a comractor(s) license Oursuant to ihe Conirectors License Lews.). ❑ I em exempl undar sec. Business and Professions Code tot IhlS reeson: Signature: Date: Owner ID veAtied by dnvefs licensa. ❑ Yes ❑ No Drivefs Licensa No. Verification of Ownership by (type of document, i.e. - properry te: bill or deetl): DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION: Expiras: ❑ I hereby certity ihat no excavation five (5) or more fael in depih into which a person is required to descend, will be mede in connection with work eu�horized by this permil, antl tha� no builtling siructure, scaffolding, falsewark, or demolition or tlismantling thereol, will be more Ihan thirty-six (36) teet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Title B, Califomia Atlminisirative Cotle). ❑ As owner-builder, I will not employ enyone to tlo work whic� would require e pertnit trom the �ivision ol Industnal Sefery, es noted above, unless such person has e pefmil to do suU work from the division. Signawre: Date: Division of Intlustrial Sefery Permit Number. CEHi1FlCATE OF COMPLIANCE AND AUfHORVATON OF ENTAY: I cehify under penalry of perjury that I have read this application antl state that the iniormation given is correct. I egree to comply ith ell state laws entl ciry orCinances relaling to building construc�lon, anO euthorize representatives of Ihe Ciry ot Costa Mesa to enler upon �he abova-described propert�r in�5peciion purposes. I egrae not to occupy or allow occupancy of any building euthorized by this permit until final inspection. COUE 1. INSPELTONTYPE 1616 Fl:ed Sys�em Flnal Fire Prevention 1266 Pool Spa Final 200 Final RB-Ro01 201 Finel BIocWRetaining Wall 202 203 204 Finel Fectory Fire Place Finel Sign Final Demolltion �g �f� �■1 COOE 1 INSPECTION iYPE 206 Finel Mechanical 20B Final Plum6ing 210 Finel Electncal 212 Final Fire Preventlon 220 Finel Planning Approval 222 Final Site 250 Finfll BuilGing/Occupancy ��/.�I�IJIIIF1Fj 1- -07 � (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.BUILDING PERMIT �� FAIR DRIVE, COSTA MESA, CA 92626 Job.4ddress: 2528 DUKE PL Suite: Vicinity: ROOF Parcel Number: 14141248 Applicant: MARTIN ARROSAGRAYS Address: 2508 BOWDOIN PL COSTA MESA, CA Owner: STRICKLER, VERN M Address 2528 DUKE PL Zoning: Phone: 714-556-8867 Zip: 92626 Phone: COSTA MESA, CA Zip: 92626 Contractor: MARTIN ARROSAGRAYS ALL SEASONS ROOFING Address: 2508 BOWDOIN PL Phone: 714-556-8867 COSTA MESA, CA Zip: 92626 License: 622480 Arch : Eng: Address: Address: Phone: Slatus: ISSUED Applied: 04/29/2003 Issued: 04/29/2003 ISSUED BY: �' Phone: Zip: License: license: SCOPE OF PERMIT TEAR OFF EXISTING ROOF. INSTALL 7/16" OSB, 1 LAYER OF 30# FELT, 30 YEAR ELK SHINGLES. 2,700 S.F. Plan Check: $0.00 Permit: $139.25 SMIP Res: $0.64 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $139.89 SETBACKS MAIN STRUCTURE Front 0- 0 ACCESSORY Front 0-0 PARKING Existinq: 0 NOTES: Rear 0- 0 Rear 0-0 Required: 0 FEE SUMMARY PLANNING & ZONING Left 0- 0 Left 0- 0 Proposed: 0 Calc Valuation: Claim Valuation: Right 0- 0 Right 0- 0 $6,350.00 $6,350.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 9248, § 1, 72-27-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspeetiona end finel approval must be obtained. Failure to obtain inspections and tinal approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 ta4geg (B�Op) WORKERS'COMpEhSAhONDECLARATON: I hereby eHirm untl0r penelry ot perjury one ot Ihe following declarations: � �, ❑ I heve antl will maintein a certifiwte oi consent to setl-Insure lor workers' compensatlon, es pmdded for by section 3700 0l t�e Lebor Code, for the pertormance of the �work tor which ihrs permil is issued. I'have antl will malrtain workers' compensation insurance, as required �y section 3700 ot the Labo� Code, for Ihe pedortnance of ihe woAc for which this pertnit is issuetl. My� r�ers�mpen�{ion In rance cartier end policy number are: ,/- /� Certier: TQ � f'✓'1 PolityNumber: /�y7S�j� '�OO� (Th/s secrion neetl not be comp/eted i! the permit is valued et one huntlred tlollers ($100) or /ess.J ❑ I certity that in the perlormence ot t�e work lar whic� this pertnit Is issuetl, I shell not employ eny person in eny manner so as to become subjed to t�e workers' compensatlon laws of Califorpia, and tnet If I should become sub�ect to the workers' compensation pmvisions ol Sectlon 3700 ot the Lebor Code, I shell forthwith comply with Ipes ro isi Ap0licamSignatur�� -`�9�-�1 / L( o�S—D3 oe�e: WARNINQ: FAILURE TO SECUFE WORKERS' COIdPENSATION WV GE IS UNLAWFUL AND SHRLL SU6IECT AN EMPLOVER TO CRIMINAL PENAI.TIES ANO CIVIL FINES UP TO ONE HUNDRED THOUSANDDOLUREIE100,000),INADDITIONTOTHECOSTOF MPENSAT�ON,DAM4GESNSPFOVI�EDPoRINSECTION3]OBOFTHELABORCODE,IPREREST,ANDATTOFiNEV'SFEES. LICENSED CONTRACTORS DECLAHATION: I hereby aflirm that � am force end eflect. Lic. N_ Contredofs Signetu�e: CONSTRUCTION LENDING AGENCV: of Chapter 9(commencing with Section 700U) pf pivision 3 0l the Business and�v t�ssions Code, afM my license is in tull � �L Cless a � Date: �— ��— ❑ I hereby aMirtn Ihat ihere is a cnnstruction lending agency for Iha perfortnence ol Ihe work tor which this permit is issuetl. (Sec. 3097, Civil Code). Lentler's Name: Lender's Atltlress: Signature: Date: OWNER-BUILDER DECLARATONS: I hereby eMlrtn that untler penalry of perjury thet I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for ihe tollowing reason (Sec. 7037.5, Business antl Professions Code: Any city or counry which requires e permit to construct, elter, improve, demolish, or repair any stmcWre, prior to its issuance, elso requires ihe applicant for such permil to file e slgned ste�6ment ihet he or she is Ilcensed pursuant to ihe provlsions oi ihe Contradors License Law (Chapter 9(commencing with Sectlon 7000) of Division 3 of the Business end Prolessions Code) or ihat he or she �s exempt therelrom end the basis for ihe elleged exemption. Any violetion of Section 7031.5 by any epplicant for a pertnit subjects the applicant to e civil penelty of not more than five hundretl tlollers (3500).): ❑ I, es owner ol the property, or my employees with wages es Ihelr sole compansation, WILL DO TT1E WORK, end Ihe siructure is not Intendetl or oHeretl for sale (Sec. 7044, Business and Professions Coae: The Coniractors License Law tloes not apply to an owner ot property who 6uilds or Improves thereon, and who tices such work himsetl or her5elf or ihrough his or her own employees, proddetl that such improvemenis are no� In�ended or oHered for sele. II, however, the builtling or improvement is sold within one year ol completion, the owner-builder wlll �ave the burden of proving ihat he or she tlid not build or improve for puryose of sela.). ' ❑ I, es owner of Ihe pra0erty, am E%CLUSNELV CONTRACTING WITH LICENSED CONTRACTORS to consWct the project (Sec. 70d4, 8usiness and Professions Cotla: The con��ac�ors License Law does not epply to an owner ol property who builtls or Improves Ihereon, and who wmracts for such projecl with e contrector(s) ticensa pursue�l to the Comractors License Laws.). ❑ I em ezempt untler sec. Signature: Owner ID venfietl by driver's license. ❑ Yes Verllicailon of Ownership 6y (type of tlocument, i.e. Business and Professions Code for this reason: ❑ No Drivefs License No. property tez bill ar deed): Date: Expires: DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATON: ❑ I hereby cetlify Ihat no ezcavation five (5) or more feet in depih into which e person is required to tlescend, wlll be me0e in connection with work authorizetl by ihis permi6 and that no builtling sirucNre, scattolding, falsework, or tlemolition or dismantling Ihereof, will he more lhan lhiRy-six (36) leet �igh. (Chap. 3.2, Grp 2, Ar12, Sec. 341, Title B, Ca�ifomie Atlministrative Code). ❑ As owner-bull0er, I will not employ enyone to do work which would require a permit }rom the Division of Indusiriel Sefery, as notetl above, unless such person has e pertnit to do sUch work tram ihe division. SignaNre: Date: Division of lndustrial Salery Pertnii Num6er: CERTIFlCATE OF CPMPLIANCE AND AUfHORVA710N OF EMRY: I certify under penalry of perjury Ihat I heve read Ihis appliw�ion end state that ihe infortnation given is correcl. I egree to comply with all state laws and ciry ordinences releting to bulitling consimction, and authorize representatives of the Clty of Costa Mesa to enter upon the ebove-described property br inspection purposes. I agree not to acupy or ellow occupancy of eny building authorized by ihis permit until final inspection. cooe �, iusvernowrteE 1616 Fixed System Final Fire Prevention 1266 200 201 202 203 204 Pool Spe Final Final Re-Rool FInaI8locWRetaining Wall Final Fectory Fira Place Final Sign Finel Demolition P� I V�LS L�L � CWE� INSPELTIONTYPE 206 Finel Mechenical 208 Finel Plumbing 210 Final Electncal 212 Final Fire Preven�ion 220 Final Planning Approval 222 Final Site 250 FinelBuilding/Occupancy Date �� It�ALg , . ' . 8 �',_��L COSTR MESA BUILDING DEPARTMENT P. 0. eOX 31] COSTA MESA, CALIFORNIA FOR APPLICANT TO FILL IN ADDREI55 252g Duke Place COSTA MESA. CALIFORNIA OWNER Mesa MAIL 1555 AO�RE55 arv N6Wpc ARCHITECT OR EN� '�ER ADDREs� $$IDE K. 47. Koll ( CONTRACTOR ADDRE55 LEGAL LOT oescaivnoN NO. A.P. NO. 5aE 63xc OF LOT t15E OF EXISTING B�DG. SETOACK L�NE FROM CENTER OG STREET SIDE VARO Inc �.��. ;��.�.,-._. . �� Sy � Fif��'„'�E � E�'T. �i� r^ , -c�. APPLICATION FOR PERMIT BUILDING FOR OFFICE USE ONLY Be3Ch Cal. TNo: MI 6-3227 ADDREI55 , 9ffiI18 uG . COSTA MESA. CALIFORNIA NO. FIRE i ^, r� ZONE ti CO• CITY LIC. ZL1! �ONE p�qHs TVPE. NO. ( / SS�B ryp. sa]j]e BPPROVED OATE BLOCK TRACT�Ot� CORRECTIONS NO.OF SO . REAF YARD 2O RIGHT S LEFT ,�O , DESCRIPTION OF WORK NEW d ALTERATION ADOITION REPAIR , I ��MOVING � �I II DEMOLISH 5 ZIE DING 1574 — 469 ROOMS 6 STORIES 1 EXTERIOR WA�L ROOF .�.,FA�N� Gtneco �o�ER�N� trood shake� rcesi Plan - The Amount shown under vzivation is for the � HEREBV RCKNOWLE�GE THAT � MPVE READ THI$ RPPLICATION PNO purpose of esta6lishing a permit fee only. STnTE THAT TME RBOVE IS CONRER nND wGREE TO COMPLV WITH nlL CITY ORDINANCE$ D STPTE LAWS GULFTING 6 ILOING CONSTPUC� •�o�. vn�unTioN SIGNATURE OF PERMIT FEE S �OO P:RMITTEE �C n��y.00 17.CQ J7� � PLAN CHECK $ � � r AUTHORIZED ENT TOTAL FEE S J�� SO VpMf